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Jarrod D Frizzell, Li Liang, Phillip J Schulte, Clyde W Yancy, Paul A Heidenreich, Adrian F Hernandez, Deepak L Bhatt, Gregg C Fonarow, Warren K Laskey
Importance: Several attempts have been made at developing models to predict 30-day readmissions in patients with heart failure, but none have sufficient discriminatory capacity for clinical use. Machine-learning (ML) algorithms represent a novel approach and may have potential advantages over traditional statistical modeling. Objective: To develop models using a ML approach to predict all-cause readmissions 30 days after discharge from a heart failure hospitalization and to compare ML model performance with models developed using "conventional" statistically based methods...
October 26, 2016: JAMA Cardiology
Shoji Nishio, Shigeo Fukunishi, Shinichi Yoshiya, David C Sing, Erik N Hansen, Thomas P Vail
The aim of this study was to examine the clinical characteristics of patients who required revision and the rate of early complications after revision for metal-on-metal total hip arthroplasty (MOM THA) and metal-on-polyethylene total hip arthroplasty (MOP THA). Matched cohorts were selected by retrospective review from a single-center database of revision THAs for failed MOM and MOP THAs from 2010 to 2014. A total of 140 hips in 140 patients comprised the study population; 39 revisions were performed for failed MOM THAs (MOM group), and 101 revisions were performed for failed MOP THAs (MOP group)...
October 25, 2016: Orthopedics
Wiliam César Alves Machado, Vera Maria da Silva, Rafael André da Silva, Ricardo Luiz Ramos, Nébia Maria Almeida de Figueiredo, Elen Martins da Silva Castelo Branco, Luciana Krauss Rezende, Mônica de Almeida Carreiro
The present qualitative study was conducted in the second semester of 2014 via interviews with 12 doctors and 13 nurses working as managers at a large hospital that serves as a reference center for urgent and emergent care in the Zona da Mata region of Minas Gerais State, Brazil. The study sought to identify the criteria that doctors and nurses use to discharge individuals with disabling neurological injury with instructions related to accessing physical rehabilitation programs. Thematic content analysis was used to examine data...
October 2016: Ciência & Saúde Coletiva
Laura Lucinda Bezerra Silva, Katia Virginia Oliveira Feliciano, Lorena Novaes Ferraz Pacheco Oliveira, Evelyne Nascimento Pedrosa, Maria Suely Medeiros Corrêa, Ariani Impieri Souza
Objective: To evaluate women's care during home visits for the "First Comprehensive Care Week". Method: A cross-sectional study was carried out in a specialized service in Recife, Pernambuco, Brazil. A total of 190 women who had recently given birth enrolled at the Family Health Strategy answered the questionnaire between September and December 2013 to verify the association between home visits and the investigated variables. This association was verified using the chi-square test with a confidence level of 95%...
October 24, 2016: Revista Gaúcha de Enfermagem
Nelly Bonifaci, Zhiling Li, Jussi Eloranta, Steven L Fiedler
The interaction potentials of the He(*)(2) excimer, in the a (3)Σu, b (3)Πg, c (3)Σg , and d (3)Σu electronic states with a ground state helium atom are presented. The symmetry of the interaction potentials closely follows the excimer Rydberg electron density with pronounced short-range minima appearing along the nodal planes of the Rydberg orbital. In such cases, a combination of the electrostatic short-range attraction combined with Pauli repulsion leads to the appearance of unusual long-range maxima in the potentials...
October 26, 2016: Journal of Physical Chemistry. A
Chuntian Cao, Hans-Georg Steinrück, Badri Shyam, Kevin H Stone, Michael F Toney
Surface sensitive X-ray reflectivity (XRR) measurements were performed to investigate the electrochemical lithiation of a native oxide terminated single crystalline silicon (100) electrode in real time during the first galvanostatic discharge cycle. This allows us to gain nanoscale, mechanistic insight into the lithiation of Si and the formation of the solid electrolyte interphase (SEI). We describe an electrochemistry cell specifically designed for in-situ XRR studies and have determined the evolution of the electron density profile (EDP) of the lithiated Si layer (LixSi) and the SEI layer with sub-nanometer resolution...
October 26, 2016: Nano Letters
Johnny J Perez, David A Watson, Robert J Levis
Nonresonant laser vaporization combined with high resolution time-of-flight mass spectrometry enables analysis of a casing after discharge of a firearm revealing organic signature molecules including methyl centralite (MC), diphenylamine (DPA), N-nitrosodiphenylamine (N-NO-DPA), 4-nitrodiphenylamine (4-NDPA), a DPA adduct and multiple unidentified features not observed in previous mass spectral measurements. Collision-induced dissociation measurements of unknown GSR signature ions reveals inorganic barium and derivatives BaOH, BaOHCH3, BaCH3COO remaining from the primer...
October 26, 2016: Analytical Chemistry
Sheng-Heng Chung, Chi-Hao Chang, Arumugam Manthiram
Sulfur exhibits a high theoretical capacity of 1,675 mA h g-1 via a distinct conversion reaction, which is different from the insertion reactions in commercial lithium-ion batteries. In consideration of its conversion-reaction battery chemistry, a custom design for electrode materials could establish the way for attaining high-loading capability while simultaneously maintaining high electrochemical utilization and stability. In this study, this process is undertaken by introducing carbon cotton as an attractive electrode-containment material for enhancing the dynamic and static stabilities of lithium-sulfur (Li-S) batteries...
October 26, 2016: ACS Nano
Kendra Irene Brown, Alexandria B Boehm
Recirculating seawater is an important component of submarine groundwater discharge, yet its role in transporting microbial contaminants from beach sand to coastal water is unknown. This study investigated the extent to which recirculating seawater carries fecal indicators, \textit{Enterococcus} and bird-associated \textit{Catellicoccus}, through the beach subsurface. Laboratory experiments and numerical modeling were performed to characterize the transport of fecal indicators suspended in seawater through medium-grained beach sand under transient and saturated flow conditions...
October 26, 2016: Environmental Science & Technology
Rui Li, Yanan Liu, Ruiwen Mu, Wenyan Cheng, Stéphanie Ognier
Petroleum hydrocarbons released to the environment caused by leakage or illegal dumping pose a threat to human health and the natural environment. In this study, the potential of a pulsed corona discharge plasma system for treating petroleum-polluted soils was evaluated. This system removed 76.93 % of the petroleum from the soil in 60 min with an energy efficiency of 0.20 mg/kJ. Furthermore, the energy and degradation efficiencies for the remediation of soil contaminated by single polyaromatic hydrocarbons, such as phenanthrene and pyrene, were also compared, and the results showed that this technology had potential in organic-polluted soil remediation...
October 25, 2016: Environmental Science and Pollution Research International
Petrina Yau-Pok Lau, Linda Katona, Peter Saghy, Kathryn Newton, Peter Somogyi, Karri P Lamsa
Long-term plasticity is well documented in synapses between glutamatergic principal cells in the cortex both in vitro and in vivo. Long-term potentiation (LTP) and -depression (LTD) have also been reported in glutamatergic connections to hippocampal GABAergic interneurons expressing parvalbumin (PV+) or nitric oxide synthase (NOS+) in brain slices, but plasticity in these cells has not been tested in vivo. We investigated synaptically-evoked suprathreshold excitation of identified hippocampal neurons in the CA1 area of urethane-anaesthetized rats...
October 25, 2016: Brain Structure & Function
Anna E Sharrock, Jenny McLachlan, Robert Chambers, Ian S Bailey, James Kirkby-Bott
BACKGROUND: The United Kingdom population is ageing. Half of patients requiring an emergency laparotomy are aged over 70, 20 % die within 30 days, and less than half receive good care. Frailty and delay in management are associated with poor surgical outcomes. P-POSSUM risk scoring is widely accepted, but its validity in patients aged over 70 undergoing emergency laparotomy is unclear. AIMS: To assess if P-POSSUM risk stratification reliably predicts inpatient mortality in this group and establish whether those who died within 30 days received delayed care...
October 25, 2016: World Journal of Surgery
Paul N Pfeiffer, Marcia Valenstein, Dara Ganoczy, Jennifer Henry, Steven K Dobscha, John D Piette
BACKGROUND: Following discharge, patients hospitalized for depression are at high risk for poor retention in outpatient care and adverse outcomes. AIMS: Pilot tests a post-hospital monitoring and enhanced support program for depression. METHOD: 48 patients at a Veterans Affairs Medical Center discharged following a depression-related inpatient stay received weekly visits or phone calls for 6 months from their choice of either a family member/friend (n = 19) or a certified peer support specialist (n = 29)...
October 25, 2016: Social Psychiatry and Psychiatric Epidemiology
Stephen Robert Puntis, Jorun Rugkåsa, Tom Burns
PURPOSE: Providing good continuity of care to patients is considered a vital component of community mental health services, but there is limited evidence that it is associated with good outcomes. We measured service use and a multidimensional concept of continuity of care in 323 patients who were to be discharged from hospital following compulsory treatment for psychosis to investigate the association between continuity and rehospitalisation. METHODS: We conducted a 36-month prospective cohort study of the patients recruited to the Oxford Community Treatment Order Trial (OCTET)...
October 25, 2016: Social Psychiatry and Psychiatric Epidemiology
Giovanni D Tebala, Sean Keane, Abdelsalam Osman, Mina Ip, Abdul Q Khan, Luciano Perrone
BACKGROUND: Enhanced recovery (ER) programs are policies and protocols meant to improve postoperative recovery after surgery. As a consequence of a smoother recovery, patients can be discharged early. This paper describes the impact of an ER program in colorectal surgery in a rural hospital. MATERIALS AND METHODS: In total, 132 patients had colorectal resection within the ER program. Data were collected prospectively. The ER pathway affects perioperative management in the following ways in order to: (1) improve patient's general condition before surgery, (2) minimize intraoperative surgical trauma by using a laparoscopic approach in all cases, and (3) facilitation of a quicker postoperative return of physiological function...
October 25, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Simon A Filson, Danielle Yarhi, Yitzhak Ramon
: The authors present 25 cases and an in-depth 4-minute video of fully awake aesthetic breast reduction, which was made possible by thoracic epidural anesthesia. There are obvious and important advantages to this technique. Not only does this allow for intraoperative patient cooperation (i.e., patient self-positioning and opinion for comparison of breasts), meaning a shorter and more efficient intraoperative time, there also is a reduction in postoperative pain, complications, recovery, and discharge times...
November 2016: Plastic and Reconstructive Surgery
Mohamed D Hashem, Aparna Nallagangula, Swaroopa Nalamalapu, Krishidhar Nunna, Utkarsh Nausran, Karen A Robinson, Victor D Dinglas, Dale M Needham, Michelle N Eakin
BACKGROUND: There is growing interest in patient outcomes following critical illness, with an increasing number and different types of studies conducted, and a need for synthesis of existing findings to help inform the field. For this purpose we conducted a systematic review of qualitative studies evaluating patient outcomes after hospital discharge for survivors of critical illness. METHODS: We searched the PubMed, EMBASE, CINAHL, PsycINFO, and CENTRAL databases from inception to June 2015...
October 26, 2016: Critical Care: the Official Journal of the Critical Care Forum
Sergio Agudelo, Oscar Gamboa, Fabio Rodríguez, Sandra Cala, Nathalie Gualdrón, Evelyn Obando, María Lucía Padrón
BACKGROUND: Human lactancy is a simple and cost-effective strategy that influences infant and maternal mortality rates. Skin-to-skin contact (SSC) is an immediate postpartum period strategy that has proven to benefit the initiation and continuation of human lactation and to decrease hospitalization during the first week of life. This study aims to determine the effect of SSC initiation at birth (immediate versus early) in healthy, full-term newborns treated at the Universidad de La Sabana Clinic on the duration of exclusive human lactation...
October 26, 2016: Trials
Parth Makker, Yuichi J Shimada, Deepika Misra, Yumiko Kanei
Therapeutic hypothermia is used in select patients after out-of-hospital cardiac arrest (OHCA) to improve neurologic outcome. Rebound hyperthermia (RH) is commonly observed post-treatment. Previous studies analyzing the association of RH with clinical outcome have reported conflicting results. The purpose of this study is to examine the impact of RH after completion of therapeutic hypothermia in patients postcardiac arrest. We analyzed a retrospective cohort from our institution. All adults who underwent therapeutic hypothermia post-OHCA were divided into two cohorts depending on the presence/absence of fever (T > 38°C) within 24 hours of completing hypothermia protocol...
October 26, 2016: Therapeutic Hypothermia and Temperature Management
Marta Tarkanovskaja, Kuno Kooser, Helena Levola, Ergo Nõmmiste, Edwin Kukk
Photofragmentation of small gas-phase acetamide clusters (CH3CONH2)n (n ≤ 10) produced by a supersonic expansion source has been studied using time-of-flight ion mass spectroscopy combined with tunable vacuum-ultraviolet (VUV) synchrotron radiation. Fragmentation channels of acetamide clusters under VUV photoionization resulting in protonated and ammoniated clusters formation were identified with the discussion about the preceding intramolecular rearrangements. Acetamide-2,2,2-d3 clusters were also studied in an experiment with a gas discharge lamp as a VUV light source; comparison with the main experiment gave insights into the mechanism of formation of protonated acetamide clusters, indicating that proton transfer from amino group plays a dominant role in that process...
September 28, 2016: Journal of Chemical Physics
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